Project Vayoraksha: Implementation of novel mHealth technology for healthcare delivery during COVID-19 in geriatric population of Kerala

Background & objectives mHealth technologies, with their potential in improving public health, have recently gained considerable interest in India, offering an opportunity to deliver tailored and low cost interventions to the selected populations, especially in resource-poor settings. Project Vayoraksha aimed at developing and pilot testing mHealth technology-assisted strategies (Vayoraksha mobile application and field Vayoraksha network) to improve healthcare delivery and reverse quarantine at the field level among the geriatric population. Methods This field operational research study was implemented in Pathanamthitta, Kerala, from October 2020 to July 2021. The Vayoraksha mobile phone application for the geriatric users and a web interface used by healthcare workers involved in the field Vayoraksha network was developed with multisectoral expertise. Vayoraksha had facilities for symptom surveillance, teleconsultation and assessment of needs and included a community-based system to monitor and meet their needs that can help in reverse quarantine of the geriatric population. Results The project was implemented using the field Vayoraksha campaign involving frontline health workers and community volunteers. A baseline survey of 4782 geriatric population in the study area was conducted in Phase I, and 2383 (49.8%) had access to a smartphone facility to use Vayoraksha. Of these, 1257 (52.7%) were covered under the 'field Vayoraksha campaign' using intersectoral coordination and community participation. A total of 750 (59.6%) geriatric individuals downloaded the application of whom, 452 (60.3%) used the services of Vayoraksha. Needs were registered by 56 (12.3%) individuals of which 46 (82.1%) were medical needs related to the management of chronic diseases. More than 70 per cent of the needs were met through the Vayoraksha field network under the local primary health centre. More than 80 per cent of the geriatric individuals reported symptoms related to COVID-19 during the intervention period. Compliance with quarantine was observed in 77.7 per cent of the geriatric populations. Among those who used Vayoraksha, 26 (5.7%) availed tele-counselling services, and 3 (0.6%) used teleconsultation facilities. It was observed that Vayoraksha users had a higher proportion of the geriatric population who were young, educated, having chronic morbidity and living with family. Regular symptom surveillance was done within this group; only 12 (2.6%) of them tested positive for COVID-19 during this study. Interpretation & conclusions Results of this pilot study are promising, with 60 per cent of the geriatric population downloading and using Vayoraksha within a short time. Technology-assisted interventions can supplement the existing system for improved healthcare delivery among the vulnerable groups and have good potential for scale-up in the near future in developing countries.